What is Bupropion?
Bupropion – also known by a variety of trade names including Wellbutrin and Zyban, and by its former international nonproprietary name (INN) amfebutamone – is a drug in the substituted cathinone class used medically for a variety of purposes including as an antidepressant and an aid to stopping smoking. It has the chemical synonyms 3-Chloro-N-tert-butyl-ß-keto-a-methylphenethylamine and 3-Chloro-N-tert-butylcathinone, and is sometimes formally known as bupropion hydrochloride. Bupropion is usually administered orally (in tablet form), though has been known to be abused intravenously and via insufflation (snorting). Legally, in the UK it is a prescription-only medicine.
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What is Bupropion Used to Treat?
Bupropion is most commonly used as an antidepressant (either by itself or as a supplementary medication in cases where first-line SSRI antidepressants have had limited results), treating clinical depression including major depressive disorder and seasonal affective disorder (SAD). It is also prescribed to aid giving up smoking: it reduces the severity and frequency of nicotine cravings and symptoms of withdrawal from nicotine dependence.
Over the last couple of decades, bupropion has also been used to treat attention deficit hyperactivity disorder (ADHD) in both children and adults; sexual dysfunction, especially hypoactive sexual desire disorder (HSDD – a chronic loss of libido) in women; and obesity. Some studies have also suggested that it may be effective as a treatment for inflammatory bowel disease and other autoimmune conditions, and neuropathic pain; however, the evidence is limited and more research is required.
Why use Bupropion for Drug Addiction
As well as its efficacy as a smoking cessation aid, there is some evidence that bupropion may be effective in the treatment of methamphetamine dependence. However, its primary use within the field of addiction treatment is as an antidepressant: depression is extremely common amongst addicts, both as a pre-existing condition and a driver of addiction, and as a withdrawal symptom, and treating depression can help address one of the major causes of addiction as well as helping to prevent relapse.
How Do Medications for Addiction Treatment Work?
Bupropion selectively inhibits the reuptake of dopamine, serotonin and noradrenaline in the brain, which means that there is more of each of these chemicals able to act upon their relevant receptors, elevating mood (and reducing cravings).
Is Bupropion Effective at Treating Addiction?
As noted above, bupropion is known to be effective in reducing cravings for nicotine, and although it has not been seen to be effective in the treatment of cocaine dependence, there is limited evidence to suggest it may be useful in treating methamphetamine dependence specifically. As mentioned earlier, however, it is considered to be most useful as an antidepressant, treating some of the drivers of addiction and some of the most problematic (and potentially dangerous) withdrawal symptoms.
Principles of Effective Bupropion Addition Treatment
What are the Side Effects of Bupropion?
The most important potential side effect of bupropion is the risk of epileptic seizures (which prompted the drug’s withdrawal from the market from 1986 to 1989). The use of antidepressants including bupropion may increase the risk of suicide, especially in individuals aged 25 or below; it has also been associated with unusual behaviour changes, while bupropion-induced psychosis may develop (while bupropion can also worsen a pre-existing psychotic condition).
Bupropion is also associated with a large number of other side effects, some of the most prominent of which include: headaches; insomnia; anxiety; constipation; nausea; tremors; sweating; itchiness; fever; dry mouth; dizziness; and agitation.
Bupropion is Most Effective when Combined with Addiction Therapy
As noted above, bupropion yields maximum benefits when prescribed as part of a holistic addiction treatment program with therapy at the core; therapy reveals and addresses the underlying causes of addiction and provides the addict with various psychological defence mechanisms against relapse, while bupropion’s efficacy is much more limited and by itself it should not be seen as a “cure” for addiction.
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